How do I know the stage of my DLBCL?

How do I know the stage of my DLBCL? Whenever people come to us, they're like, what stage am I? That's always a question that we get. So staging blood cancers is slightly different than staging solid tumors, for example, breast cancer or pancreatic cancer. Again, the stages for DLBCL also run from stage one to four. And traditionally, we have used a system called the Ann Arbor staging system, which basically stages people from one to four, depending on the number of lymph node sites that are involved. So if you just have one site of disease involved in stage one, if you have more than two sites, but they are all on the same side of the diaphragm, you call it a stage two. If you have disease on both sides of the diaphragm, it's stage three. And if you have more widespread disease, it's stage four. So the question always comes, I have stage four disease. Does that mean that it's incurable? The answer is no. Even if you have advanced stage disease, diffuse large B-cell lymphoma is still a potentially curable disease. Stage matters. Obviously, limited stage, stage one, two disease is going to do better than somebody with stage four disease. But again, the chances of still going for a potential cure, that is our aim in this disease. It's a bit different than other types of cancers, such as lung cancer or breast cancer. We use something called Lugano staging system. So it basically is graded on involvement of different sites. So if a patient has only one area of lymph node involvement, that's stage one. If they have multiple areas of lymph nodes involved, but they're just on one side of the diaphragm, let's say in the neck and the chest or in the abdomen or the groin, it's considered stage two. Stage one and two are considered early stage disease. And some of these patients might qualify for shortened treatment, four cycles instead of six cycles. If the disease is involving on both sides of the diaphragm, let's say there is a lymph node in the neck and there is a lymph node in the abdomen, this is considered stage three. Stage four is when there is organ or bone marrow involvement, such as it could be kidneys, liver, it could be the brain or the lungs. People usually get very scared when they find out that they have stage four diffuse large B cell lymphoma. But again, even at least 50 to 60% of stage four diffuse large lymphoma and probably a higher percentage with the modernized treatment approaches are going to be curable from their disease. So it's not the end of the road. By no means it's again remains to be a very curable malignancy even in stage four patients. Once a patient is diagnosed with a disease, we undergo a series of imaging studies to understand where the disease is spread. And that we call staging. And eventually after that, the patient started to receive the treatment that I said before in general consists in the administration of immunotherapy in combination with four different chemotherapies altogether. The treatment usually takes place between the diagnosis and the treatment. We have a different way to stage of prognostic the patients because this is pretty much disseminated from the very beginning lymphocytes, B lymphocytes are everywhere. So the disease can affect simultaneously different organs, lymph nodes. So it can be more or less spread and that goes with the staging, but also it can be more or less aggressive depends on the mutations that drive the disease. So it's not in that regard, it's not very similar to solid tumor that is more, you know, it's have like early stages and eventually metastasis. For this disease, it's like it's disseminated pretty much from the very beginning. That's why the treatment most of the time involves the administration of chemotherapy and immunotherapy. You have like a surgery or thing like that. It's rare. It can be sometimes used, but in combination with this one because it's a spread disease from the beginning. But there are different degrees of aggressiveness, if you want to put it that. And that depends on the molecular constitution of the disease. So they're more or less aggressive. And also in the sarandisate that I mentioned before, the microenvironment can make this disease more or less aggressive.